The only certainty about California’s aid-in-dying law is that it is not the law at the moment.

The End of Life Option Act, signed by Gov. Jerry Brown in 2015 and taking effect the following year, allowed people with six months or less to live to obtain lethal medication they could use to end their lives.

Riverside County Superior Court Judge Daniel A. Ottolia overturned the law on May 15, saying it was unconstitutional because of how it was passed — in a special session of the Legislature dedicated to health care issues.

Although it appeared an appeal by California Attorney General Xavier Becerra meant the law would stay in effect at least temporarily, Becerra’s request for an immediate stay was denied. When Ottolia officially filed his ruling late last week, it meant the law had been invalidated, although that could still change through a reversal or a stay.

On Wednesday, Ottolia rejected a motion filed by two people with terminal cancer and a physician to reverse his ruling. He also set a hearing for June 29 to consider a motion by Becerra to vacate the earlier ruling.

The roller coaster has left patients and doctors confused or unaware of the law’s status.

“We’re all questioning what the heck is going on right now,” said Dr. Lanyard Dial, president of Livingston Memorial Visiting Nurse Association. The hospice with offices in Ventura, Ojai and Thousand Oaks doesn’t prescribe medications under the aid-in-dying law but has patients who have already obtained the prescriptions.

The ruling means people can no longer use the law to obtain lethal medications from doctors, said leaders of the Death With Dignity organization who support the law and have begun fundraising for what they predict will be a protracted court battle.

The ruling, said Death With Dignity leaders, also stops the process for people who have started but have not completed a path that includes assessments by two doctors, a decision on mental competency and a determination the person can take medication without outside help.

As of a year ago, more than 500 Californians had received prescriptions for medical aid, according to data from the Compassion & Choices group. That list includes Betsy Davis, of Ojai, who was diagnosed with amyotrophic lateral sclerosis — Lou Gehrig’s disease. She ingested the drugs and ended her life after a farewell party with friends and family at her rental home on July 24, 2016.

“It was so important to her and she was suffering. We knew this is what she wanted,” said her sister, Kelly Davis, adding that the judge’s decision that the law was unconstitutional stunned her.

“I was like, ‘Oh, my God.’ What if we had been at this point now and this had come around?” she said, then answering her own question. “She would have done it anyway.”

It is unclear what will happen to people who disregard the court ruling and use lethal medication obtained when the law was still in effect. If they end their lives, they can’t be prosecuted, said Stephen Larson, an attorney for doctors who filed a lawsuit two years ago to overturn the law in the Riverside County case.

“It is beyond the reach of the law,” Larson said.

John Kappos, a lawyer involved in a motion aimed at vacating the ruling and restoring the law, said it’s not clear whether the Riverside County decision is retroactive and affects people who have already obtained prescriptions but have not yet used them.

The ruling specifically bans the state from recognizing or enforcing the End of Life Option Act and also prohibits the Riverside County district attorney from recognizing any protections offered through the law.

The impact on the Ventura County District Attorney’s Office is unclear, said Michael Schwartz, chief assistant district attorney for the county. Citing the rarity of assisted suicides and the possibility of changes in the Riverside County ruling, he said it’s very unlikely a local case would emerge in which patients or doctors ignore the ruling.

“If it does come up, we’ll have to do further research,” he said.

The ruling has revived the conversation that swept across California before the law was passed. Supporters cite polls suggesting a majority of Calfornians support the law. Others cite advances in pain care medication used in hospice and palliative care.

“You can do it without accelerating death,” said Father Tom Elewaut, pastor of Mission San Buenaventura, telling of how he recently prayed with a 95-year-old man just before he died in a hospital.

“He allowed nature to take its course in a natural setting,” Elewaut said. “It doesn’t have to be all or nothing.”

Dr. Jack Padour, a Ventura internist, said he has prescribed life-ending medication to five patients since the law became effective in June 2016, and two of them came from outside Ventura County; all were referred by hospice care or other doctors.

“There are so few doctors who are willing to help the patients,” Padour said, noting that he would comply with the ruling and no longer prescribe medication unless the decision is reversed or stayed.

But he said the reality of the law being voided is that some people in pain won’t be able to control how they die.

“They’re suffering,” he said. “They simply want the option to die with some dignity.”

Lawyers on both sides said the court battle could reach the California Supreme Court. Supporters of the law also circle the June 29 hearing in Riverside County Superior Court.

Larson, the attorney in the litigation against the End of Life Option Act, thinks the battle might ultimately end up where it started — in the Legislature. If a similar measure is passed, it should include far more protections that prevent the law’s misuse, he said.

“Even proponents of assisted suicide should be gravely concerned with the lack of safeguards in this particular statute,” he said.

But those safeguards are already part of the law, said Kappos, who filed a motion to vacate the Riverside County ruling on behalf of a man with terminal melanoma, a second cancer patient who obtained lethal medication through the law but is now afraid to use it and a physician. The motion was denied.

“There is no requirement for those morally opposed to opt-in,” Kappos said. “But those who are morally opposed should not dictate whether others opt-in. It is a personal decision.”